RESEARCH PROPOSAL WORKSHOP REGISTRATION FORM
THIS RESEARCH IS ORGANIZED BY: AFRICA CENTRE OF EXCELLENCE IN PUBLIC HEALTH AND HERBAL MEDICINE (ACEPHEM) AND RESEARCH AND TRAINING CONSULTANCY INTERNATIONAL (RTCI)
Full Names: *
Your answer
Title *
Your answer
Gender *
Nationality (if dual give both) *
Your answer
Country of birth: *
Your answer
What is your preferred telephone No/Mobile No: *
Your answer
Additional Telephone No/Mobile No:
Your answer
Preferred e-mail: *
Your answer
Institution undertaking your research or studies *
Your answer
Current level of study: *
Year of study: *
Degree of study: *
Your answer
Stage of study (which stage at proposal development):
Current Job Title: *
Your answer
How did you learn about the ACEPHEM Course? (this course) *
Required
Have you attended ACEPHEM Course before? *
State two, most challenging areas of your research journey *
Your answer
What are your expectations for the course? (at least two) *
Your answer
The training fees is fully paid. If you miss the scholarship, would you like to pay to attend? *
End
Having been invited to the workshop and awarded the scholarship, I commit to:
1. Attend from 8:30am to 4:30pm daily for the 5 days.
2. Participate in the group work and deliver assignments on time.
3. Bring a laptop
4. Bring a draft concept or proposal (optional)
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